Systems and methods for image-guided navigation of percutaneously- inserted devices

Patent metadata

Field	Value
Publication number	US-2021085268-A1
Application number	US-202017013107-A
Country	US
Kind code	A1
Filing date	Sep 4, 2020
Priority date	Sep 24, 2019
Publication date	Mar 25, 2021
Grant date	—

Abstract

Systems and methods for image-guided medical procedures use fluoroscopic 3D reconstructions to plan and navigate a percutaneously-inserted device such as a biopsy tool from an entry point to a target.

First claim

1 . A method of performing an image-guided medical procedure, comprising:
receiving fluoroscopic images from a fluoroscopic sweep of at least a portion of a patient's body that includes a target area; determining a fluoroscopic pose for each of the fluoroscopic images; generating a fluoroscopic three-dimensional (3D) reconstruction based on the fluoroscopic images and the fluoroscopic poses; applying a trajectory of a percutaneously-inserted device to the fluoroscopic 3D reconstruction such that the fluoroscopic 3D reconstruction includes a planned trajectory; displaying a live fluoroscopic image; overlaying the planned trajectory of the percutaneously-inserted device on the live fluoroscopic image; displaying advancement of a percutaneously-inserted device a first distance in the live fluoroscopic image; determining at two angles that the advancement of the percutaneously-inserted device the first distance is following the planned trajectory; displaying advancement of the percutaneously-inserted device a second distance in response to determining at two angles that the advancement of the percutaneously-inserted device the first distance is following the planned trajectory; and determining at two angles that the advancement of the percutaneously-inserted device the second distance is following the planned trajectory.

2 . The method of claim 1 , further comprising:
applying a mark indicating a critical structure to avoid to the fluoroscopic 3D reconstruction; and overlaying the mark indicating the critical structure to avoid on the live fluoroscopic image.

3 . The method of claim 1 , wherein the planned trajectory includes a target, an insertion point, and a line between the insertion point and the target.

4 . The method of claim 3 , wherein the fluoroscopic sweep is performed after insertion of the percutaneously-inserted device at the insertion point.

5 . The method of claim 1 , wherein the fluoroscopic images include fluoroscopic images of a radiopaque object, further comprising:
determining the position of the radiopaque object relative to the target; and determining the position of an insertion point based on the position of the radiopaque object relative to the target.

6 . The method of claim 1 , further comprising:
determining that the percutaneously-inserted device is located at the target; and receiving one or more additional fluoroscopic images from one or more additional fluoroscopic sweeps in response to determining that the percutaneously-inserted device is not located at the target.

7 . The method of claim 1 , further comprising receiving preoperative computed tomography (CT) images including markings indicating the planned trajectory; and
registering the fluoroscopic 3D reconstruction to the preoperative CT images; transferring the markings on the preoperative CT images to the fluoroscopic 3D reconstruction based on the registering; and overlaying the fluoroscopic 3D reconstruction including the transferred marking on the live fluoroscopic image.

8 . The method of claim 7 , wherein the registering includes:
determining one or more anatomical features that are in both the fluoroscopic 3D reconstruction and the preoperative CT images; and aligning the fluoroscopic 3D reconstruction and the preoperative CT images based on the determined one or more anatomical features.

9 . The method of claim 8 , wherein the one or more anatomical features includes the target, a lesion, a tumor, or a rib.

10 . A method of performing an image-guided medical procedure, comprising:
receiving first fluoroscopic images from a first fluoroscopic sweep of at least a portion of a patient's body that includes a target area; determining a pose for each of the first fluoroscopic images; generating and displaying a first fluoroscopic 3D reconstruction based on the first fluoroscopic images and the poses; marking a planned trajectory in the first fluoroscopic 3D reconstruction; displaying a live fluoroscopic image; overlaying the planned trajectory on the live fluoroscopic image; adjusting the live fluoroscopic image such that the trajectory appears as a point; and displaying advancement of a percutaneously-inserted device along the planned trajectory based on the adjusted live fluoroscopic image.

11 . The method of claim 10 , further comprising displaying the length of the planned trajectory,
wherein the percutaneously-inserted device is advanced based on the length of the planned trajectory and length markers on the percutaneously-inserted device.

12 . The method of claim 10 , wherein the planned trajectory includes an insertion point, a target, and a line between the insertion point and the target.

13 . The method of claim 10 , further comprising adjusting the live fluoroscopic image to a second angle to verify the depth of the percutaneously-inserted device in the patient's body.

14 . The method of claim 13 , further comprising adjusting the live fluoroscopic image to a third angle to verify the direction of the percutaneously-inserted device.

15 . A method of performing an image-guided medical procedure, comprising:
receiving first fluoroscopic images from a first fluoroscopic sweep of at least a portion of a patient's body that includes a target area; determining a first fluoroscopic pose for each of the first fluoroscopic images; generating and displaying a first fluoroscopic 3D reconstruction based on the first fluoroscopic images and the first fluoroscopic poses; applying a trajectory of a percutaneously-inserted device to the first fluoroscopic 3D reconstruction such that the first fluoroscopic 3D reconstruction includes a planned trajectory; displaying a live fluoroscopic image; overlaying the planned trajectory of the percutaneously-inserted device on the live fluoroscopic image; receiving second fluoroscopic images of an insertion point from a second fluoroscopic sweep; determining a second pose for each of the second fluoroscopic images; generating and displaying a second fluoroscopic 3D reconstruction based on the second fluoroscopic images and the second poses; and displaying insertion of a percutaneously-inserted device in the live fluoroscopic image.

16 . The method of claim 15 , further comprising:
registering the second fluoroscopic 3D reconstruction to the first fluoroscopic 3D reconstruction; and transferring the planned trajectory applied to the first fluoroscopic 3D reconstruction to the second fluoroscopic 3D reconstruction based on the registering.

17 . The method of claim 15 , further comprising:
displaying the live fluoroscopic image in at least one fluoroscopic angle after advancement of the inserted percutaneously-inserted device a first distance; and determining that the advancement of the inserted percutaneously-inserted device the first distance is following the planned trajectory based on the live fluoroscopic image in the at least one fluoroscopic angle.

18 . The method of claim 17 , wherein the at least one fluoroscopic angle includes two different fluoroscopic angles at which a direction of the inserted percutaneously-inserted device can be determined from the live fluoroscopic image.

19 . The method of claim 17 , further comprising:
displaying the live fluoroscopic image in at least one fluoroscopic angle after advancement of the inserted percutaneously-inserted device a second distance; and determining that the advancement of the inserted percutaneously-inserted device the second distance is following the planned trajectory

Assignees

• Covidien Lp

Inventors

• Alexandroni Guy
• Weingarten Oren P
• Kopel Evgeni

Classifications

• A61B2090/367

  creating a 3D dataset from 2D images using position information · CPC title

• A61B2034/107

  Visualisation of planned trajectories or target regions · CPC title

• A61B6/5235

  combining images from the same or different ionising radiation imaging techniques, e.g. PET and CT · CPC title

• A61B6/032

  Transmission computed tomography [CT] · CPC title

• A61B6/022

  Stereoscopic imaging · CPC title